EMPLOYERS PAY FOR SANATORIUM CARE
Massachusetts, almost invariably a leader in preventive measures, is developing this year a most unique and promising kind of co-operative effort in the prevention of tuberculosis. Massachusetts was the first state to organize a board of health, dating from 1869. It was the first state to choose its factory inspectors from the medical profession, this dating from 1906, and out of these two farsighted provisions of the law has grown during the past two months a plan by which manufacturers are assuming a part of the financial burden in seeing to it that operatives in their factories, found to have tuberculosis in the incipient stage, are sent to the Rutland Sanatorium and given the best possible opportunity for cure.
The plan originated in Worcester which, with a string of neighboring towns and villages, forms one of the sixteen inspection districts into which the state is divided. As a result of the activity of Dr. M. G. Overlock, the state inspector of health in charge, seventy manufacturing plants, employing more than 20,000 hands, have followed the example of David H. Fanning, president of the Royal Worcester Corset Company, in agreeing to pay a part of the maintenance cost of any of their employes sent to Rutland. The cost in the sanatorium is nine dollars a week. Of this the state pays five dollars and the company four dollars. The term usually agreed upon is three months. At the end of that time, a large number of the cases have been so far restored that they can be taken to nearby, supervised boarding houses and farms and make room for new patients,—a plan hit upon to relieve the great pressure upon this institution which accepts only incipient cases. The employer continues his contribution. The boarding houses, conducted along approved lines, have sprung up all over the surrounding hills much as they have at Saranac Lake in New York.
The factory inspection has been keyed up to take the greatest possible advantage of the co-operation of employers. Frequent visits are made to all plants, but to those in which the work rooms are full of dust, or where there are other conditions favoring tuberculosis, Dr. Overlock makes a visit once a month. All minors on the working staff are taken before him, and required to furnish a full family history. If there has been tuberculosis in the family, even remote, a medical examination is at once made. The others are examined more superficially, but the least trace of suspicious symptoms is at once seized upon as cause for an examination. In this way, it is believed, incipient cases among minors will be caught in their earliest stages. The system will later be extended to adults. An extension of the plan to secure the interest and help of employers has begun in some other inspection districts, and will eventually be introduced throughout the state.
But the carefully laid plans to detect and ward off incipient cases comprise only one part of the Massachusetts plan to fight tuberculosis. In May three homes for advanced cases will be opened, and the development of the plan calls for additional homes, scattered through the state, until it shall have made complete provision for all cases, early or advanced. In view of the almost unanimously expressed opinion at the recent International Tuberculosis Congress, that the strategic point of attack in the campaign is in isolating advanced cases, the provision of these homes is, perhaps, the most important plank in the Massachusetts health platform. Governor Guild is much interested in the whole plan. In a recent letter to Dr. Overlock he wrote: "It has been a great pleasure for me to inaugurate the new policy of the commonwealth of provision for all cases of tuberculosis, not merely as at present the care of the curable, but the care of the incurable as well."